JOURNAL OF TROPICAL PEDIATRICS, VOL. 60, NO. 3, 2014

Co-morbidities in Children Presenting with Chronic Suppurative Otitis Media—A South African Study by Ute M. Hallbauer,1 Mark D. Atkins,1 Nicholas J. Tiedt,2 Iain R. T. Butler,2 Madeleine Pieters,3 Eugene Elliott,3 Gina Joubert,4 and Riaz Y. Seedat2 1 Department of Paediatrics and Child Health, University of the Free State, Bloemfontein 9300, South Africa 2 Department of Otorhinolaryngology, University of the Free State, Bloemfontein 9300, South Africa 3 Department of Medical Microbiology, NHLS and University of the Free State 4 Department of Biostatistics, University of the Free State, Bloemfontein 9300, South Africa

Summary Background: Chronic suppurative otitis media (CSOM) is common among children in southern Africa. Managing associated co-morbidities may result in earlier disease resolution. Methods: Children 4 weeks were recruited to the study. Each child underwent a full clinical examination, a blood count, an HIV test and CD4 cell count, if found to be infected. Results: The study included 86 children, and the median age was 4.6 years. HIV infection was present in 45 of 83 children (54.2%), of which 23 (51.1%) were receiving antiretroviral treatment at the time of presentation. Underweight was present in 22 of 85 (25.9%) children and in 17 of the 45 (37.8%) HIVinfected children. One or more clinical signs (not aural-related) were found in 46 of 86 (53.4%) children. Cholesteatoma was found in 23 of 113 (20.4%) ears, and 9 of 86 (10.5%) children had serious associated aural or intracranial complications. Conclusions: A high percentage of children with CSOM have associated pathology that needs to be diagnosed to optimally manage CSOM. Key words: chronic suppurative otitis media, co-morbidity, HIV infection, malnutrition, children

Acknowledgements The authors thank the nursing staff of the paediatric clinics (Pelonomi and Universitas Hospitals) and the ENT clinic at Universitas Hospital for their assistance during the study. The findings were presented at the: FIDSSA (Federation of Infectious Diseases Societies South Africa) Congress, 2011; Annual Academic Forum, Faculty of Health Sciences, University of the Free State, 2011; South African Society of Otorhinolaryngology: Head and Neck Surgery Congress, 2011. U.M.H. and M.A. conceived the idea, assisted with writing the study protocol, collected and analysed data, performed literature search and prepared and reviewed the manuscript. R.Y.S., J.T., I.R.T., M.P. and G.E. refined the idea, assisted with writing the study protocol, collected and analysed data, performed literature search and prepared and reviewed the manuscript. G.J. reviewed the study protocol, analysed data and reviewed the manuscript.

Introduction Chronic suppurative otitis media (CSOM) is a chronic infection of the middle ear cleft, in which the tympanic membrane is not intact and otorrhoea is present [1, 2]. CSOM is common; the prevalence is approximately 2% among children in southern Africa [3–5] and between 0.4 and 4.2% in other African countries [6, 7]. Most cases of CSOM in Africa occur in children, especially in younger children aged

Co-morbidities in children presenting with chronic suppurative otitis media--a South African study.

Chronic suppurative otitis media (CSOM) is common among children in southern Africa. Managing associated co-morbidities may result in earlier disease ...
170KB Sizes 0 Downloads 0 Views